Choose wisely! Not all "therapists" are the same...

WARNING: A BIG OL' RANT!

There are many well-meaning people where I live and work who have trained, practised and developed competence in many, varied forms of therapy. Physical therapy is, obviously, a different category to psychotherapy. Coaching is, again, a different discipline. This post is about the support needed for the deepening mental health crisis.

Given the significant level of need here - and I'm talking about mental health needs - it's vital that the public have access to support alongside (or instead of) the official NHS-led services that, sadly, are deeply under-resourced and stretched to breaking point.

I have held off on this post for a while, biting my tongue and waiting until I felt justified in 'going public' with my opinions. And let me emphasise: they are my subjective opinions and others are entitled to disagree. So, here goes:!

The other day (and please accept that this happens more often than I care to admit) I met someone who, as part of their profile, assigns the title "psychotherapist" as one of her professional designations. It is not true.

I fully recognise that most people do not understand the often subtle differences between the terms psychotherapy, coaching, therapeutic coaching, life coaching, 'therapy' (generic); furthermore, there is a plethora of styles and approaches including DBT, CBT, TF-CBT, Trauma-informed coaching, Hypnosis, 'clinical' Hypnosis, IFS, NLPt and many more, not to mention the multitude of specific interventions such as EMDR, EFT, Art Therapy, Dance Therapy, Equine Therapy, Transactional Analysis....the list seems endless.

It should not be underestimated that people are genuinely challenged when determining what sort of therapy might be most helpful for their particular problems.

But even more serious, I believe, is when those in the field of therapy (and coaching) present themselves in potentially misleading ways.

My experience is that clients have variable 'levels' and types of problems. Simply put: as therapists, we should be able to (i) recognise what's walking through the door of our practice; (ii) be able to evaluate whether the problems can be appropriately and adequately addressed via our commensurate levels of skills and knowledge; and (iii) be wise, humble and self-reflective enough to refer out to another, more seasoned professional if we feel we cannot help the client. This last point is as important as the other two: we MUST know not only our limits but also be prepared to not engage with a presenting problem that we are not equipped to deal with.

And here's the issue: in general, the title "psychotherapist" goes to those with extensive experience and training in dealing with those genuinely tricky problems that often cannot be addressed by "therapists" or "coaches". Often these are problems relating to serious abuse, trauma, affect dysregulation and attachment disorders, personality disorders and other serious conditions.

A word about "trauma". This word is now ubiquitous and more and more clients are seeking help to address trauma-related problems. Whilst many 'low-level' traumas can indeed be addressed through a range of interventions more readily understood by most coaches or therapists, the more significant traumas need careful handling and, sometimes, months or even years of intensive therapy from experienced psychotherapists.

There are two other criteria, as far as I can see: first, that the psychotherapist is in regular therapy themselves and/or has regular supervision with a clinical supervisor who, in turn, can monitor and guide the therapist in their work. Second, that this individual has gained enough self-awareness and insight to know what do to when things get tough with the work and/or has enough self-awareness and personal insight (and an ego that's kept in check) to not take a client on in the first place if they know in their bones they shouldn't!

I know that in my early years in practice, I did good work. But now, after almost 25 years, I feel more confident that I can recognise a client needing a coach, a client needing 'low-level' talking intervention/therapy and a client specifically requiring psychotherapy.

Working with vulnerable, often frightened and wounded people is both a privilege and a responsibility.

I appeal to my colleagues in my local area to consider how they are representing themselves. Psychotherapy is, in the end, a legally regulated field (where coaching is not, currently). Our field is, quite rightly, under scrutiny, and it's simply not ok to claim, for example, that a qualification in "hypnosis" allows you to work with any mental health condition. By the same token, a qualification in NLP (even to "Master Practitioner") does not mean you can call yourself a "Psychotherapist" - NLP is not a recognised psychotherapy in itself, nor has it ever claimed to be!

And while I'm on a roll, there is "good" NLP and "less than good" NLP. The ANLP is an organisation dedicated to developing, promulgating and encouraging high standards in NLP training, qualifications and practice. As a ANLP Ambassador, I'm always keen to connect with NLP colleagues; again, it's sad when I find that some in my local geography who claim qualifications and experience in NLP simply do not have the depth of knowledge, insight, experience or integrity that ANLP is aiming to establish as a baseline for the profession.

And while I'm on this rant (sorry) the same is true for those that claim the title "Coach".

I'm not saying you HAVE to get a qualification to help people! Whether coaching or therapy, qualifications alone do NOT guarantee good practice; I think we all know that.

But it's equally important to know what you can and cannot do with clients - hence the importance of coaching supervision too. The self-awareness needed to refer out to a more experienced coach was a critical part of my own learning at the start of my career. Yes, new coaches have to start somewhere. But for the good of the profession and on behalf of clients' outcomes, let's create a community of practice where we can raise the bar of quality for island people and help each other grow our skills and knowledge in genuinely professional and accountable ways.

Whatever we call ourselves and however we market our services, we must be honest, transparent and accountable. And above all else, as therapists we must continue to develop ourselves through our own ongoing learning, supervision (and clinical supervision if working in a clinical context) and recognise that our work with clients will only ever be as good as the practitioner's own emotional stability, self-awareness and modesty.

If you or any of the people you work with or any friends, family or neighbours need advice on coaching, therapy and what next steps they could take, I'm very happy to advise. It's a mixed and murky field out there - and the public need to know what's available, what's suitable and who is out there in my area that seem to be working in ethical, robust and professional ways!